Fentanyl Facts

Key points

  • Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.
  • It is a major contributor to fatal and nonfatal overdoses in the U.S.
the facts about fentanyl

The facts about fentanyl

There are two types of fentanyl: pharmaceutical fentanyl and illegally made fentanyl. Both are considered synthetic opioids (made in a laboratory). Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer.

However, most recent cases of fentanyl-related overdose are linked to illegally made fentanyl, which is distributed through illegal drug markets for its heroin-like effect.1 It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous.

Illegally made fentanyl

Illegally made fentanyl (IMF) is available on the drug market in different forms, including liquid and powder.2

Powdered fentanyl looks just like many other drugs. It is commonly mixed with drugs like heroin, cocaine, and methamphetamine and made into pills that are made to resemble other prescription opioids. Drugs mixed with fentanyl are extremely dangerous, and many people may be unaware that their drugs contain it.

In its liquid form, IMF can be found in nasal sprays, eye drops, and dropped onto paper or small candies.

Fentanyl and overdose

Synthetic opioids like fentanyl contribute to nearly 70% of overdose deaths.3 Even in small doses, it can be deadly.456 Over the last few years, nonfatal and fatal overdoses involving fentanyl have continued to rise.457

Drugs may contain deadly levels of fentanyl, and you wouldn't be able to see it, taste it, or smell it. It is nearly impossible to tell if drugs have been mixed with fentanyl unless you test your drugs with fentanyl test strips.

Test strips to detect fentanyl are inexpensive and typically give results within 5 minutes, which can be the difference between life or death. Even if the test is negative, take caution as test strips might not detect more potent fentanyl-like drugs, like carfentanil.6

Fentanyl mixed with Xylazine is an emerging threat‎

Xylazine is a non-opioid sedative that is increasingly being found in the US illegal drug supply and linked to overdose deaths. Xylazine can be life-threatening and is especially dangerous when combined with opioids like fentanyl.
  1. O'Donnell J, Tanz LJ, Gladden RM, Davis NL, Bitting J. Trends in and Characteristics of Drug Overdose Deaths Involving Illicitly Manufactured Fentanyls — United States, 2019–2020. MMWR Morb Mortal Wkly Rep 2021;70:1740-1746. DOI: http://dx.doi.org/10.15585/mmwr.mm7050e3external
  2. https://www.dea.gov/sites/default/files/2020-06/Fentanyl-2020_0.pdf
  3. Centers for Disease Control and Prevention, National Center for Health Statistics. National Vital Statistics System, Mortality 2018-2021 on CDC WONDER Online Database, released in 2023. Data are from the Multiple Cause of Death Files, 2018-2021, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed at http://wonder.cdc.gov/mcd-icd10-expanded.html on Mar 5, 2024
  4. Spencer MR, Miniño AM, Warner M. Drug overdose deaths in the United States, 2001–2021. NCHS Data Brief, no 457. Hyattsville, MD: National Center for Health Statistics. 2022. DOI: https://dx.doi.org/10.15620/cdc:122556
  5. Shannon M. Casillas, Lawrence Scholl, Desiree Mustaquim, Alana Vivolo-Kantor. Analysis of trends and usage of ICD-10-CM discharge diagnosis codes for poisonings by fentanyl, tramadol, and other synthetic narcotics in emergency department data, Addictive Behaviors Reports, Volume 16, 2022, 100464, ISSN 2352-8532, https://doi.org/10.1016/j.abrep.2022.100464.
  6. Bergh, Marianne Skov-Skov et al. "Selectivity and sensitivity of urine fentanyl test strips to detect fentanyl analogues in illicit drugs." The International Journal on Drug Policy. Vol. 90 (2021): https://doi.org/10.1016/j.drugpo.2020.103065
  7. Centers for Disease Control and Prevention. State Unintentional Drug Overdose Reporting System (SUDORS). Final Data. Atlanta, GA: US Department of Health and Human Services, CDC; [2024, March 8]. https://www.cdc.gov/drugoverdose/fatal/dashboard